On September 10, 1939, one day after Canada entered the war, Macham enlisted in the
Royal Canadian Army Medical Corps as a Nursing Sister. When Macham first enlisted in 1939, she held the rank of Lieutenant (Nursing Sister). She worked at the No. 15 Canadian General Hospital (CGH), which originated in the Toronto Military Hospital. In June 1940, she was transferred to the United Kingdom in one of the earliest groups of Canadian Nursing Sisters, travelling by ships in
convoys alongside the soldiers. In the United Kingdom, Macham served in the operating room at the No. 15 CGH in
Bramshott Chase. In 1941, she was transferred to an innovative
plastic surgery unit in
Basingstoke, England, and was promoted to Nursing Sister-in-Charge. Macham later credited her experience in the operating room at Women’s College Hospital as a key factor in her recruitment to this role. In the summer of 1943, she was transferred to the No. 5
Casualty Clearing Station,. travelled over England and
Italy. Macham was promoted to Captain (Matron). In the summer of 1944, Macham moved to the No. 8 CGH, which was stationed in England, the
Netherlands,
France and
Belgium. Later in 1944 she was stationed at hospitals in Holland and
Antwerp. In December 1944, Macham was promoted to Major (Principal Matron). While in Antwerp, she once again was on the front lines, as part of the city was still a dangerous battleground. At the end of the war, Macham took on the task of closing several Canadian General Hospitals. Years later, when asked why she had enrolled in the military, Macham responded “I was patriotic; this was an opportunity to do something different.” == Postwar service ==